
Quiz Question
In Caldeira 2025 et al., on femoral neck fixation, what complication was more likely with the three-screw construct?
🔍 Key Findings
Design: In vitro study on cadaveric femurs (n=21) with basilar femoral neck fractures stabilized using 2 vs 3 titanium cannulated screws.
Stiffness: Control > 3-screw > 2-screw (674 > 120 > 90 N/mm).
Yield Load: 3-screw (586 N) > 2-screw (303 N); both < intact femur (2692 N).
Displacement: No difference across groups.
Complication: 3-screw technique more demanding; higher risk of cortical perforation, especially with narrow femoral necks.
Failure Mode: Dislodgement of femoral head + screw shaft bending.
Conclusion: 3 screws = stronger construct than 2 screws. Clinical implications need further study.
Veterinary and Comparative Orthopedics and Traumatology
1
2025
In Vitro Biomechanical Study of Femoral Neck Fracture Fixation with Two or Three Cannulated Screws in Dogs
2025-1-VC-Caldeira-3
In Banks 2024 et al., on postoperative outcome, what was the median achieved TPA in the full clinical sample?
🔍 Key Findings Summary
- Study Design: Retrospective study of 100 radiographs using in silico and clinical data
- Mean preoperative TPA: 28.6°, higher in small dogs than large (p = .02)
- Mean planned TPA (in silico): 7.6°, not achieving 5° target (p < .01)
- Median postoperative TPA: 5.5° overall; higher in small dogs (7°) vs large (4.5°) (p = .06)
- Postoperative ostectomy position: More distal than recommended; average = 8.6 mm
- Increased distalization → greater under-correction of TPA (p = .01)
- Most accurate correction occurred when ostectomy was ≤7.5 mm from patellar tendon
- Wedge angle categories (TPA-Pre minus 5–2°) were used based on pre-op TPA
Veterinary Surgery
1
2024
A mismatch of planning and achieved tibial plateau angle in cranial closing wedge surgery: An in silico and clinical evaluation of 100 cases
2024-1-VS-banks-1
In Eskelinen 2025 et al., on Plate–Pin fixation for MPL, what was the authors’ recommendation regarding the number of screws for TT fixation?
🔍 Key Findings
- Plate–Pin TTT fixation resolved MPL in 64/65 stifles with low recurrence (1.5%) and good lameness outcomes postoperatively.
- Complication rate was 21.5% (14/65 stifles), mostly minor (57%); major issues included pin migration, fracture, or capsular failure.
- Pin-related issues accounted for 8 of 20 total complications, highlighting implant refinement is needed.
- No avulsions, TT fixation failures, or luxation recurrence occurred in cases where surgical technique was followed precisely.
- Surgical deviations increased complication risk 11.3Ă— (p < 0.05), suggesting adherence to protocol is critical.
- Single-session bilateral MPL surgery had comparable complication rate (3/20) to unilateral surgery (11/45).
- Screw breakage occurred in 3 cases, suggesting at least 3 screws may be needed for secure TT fixation.
- Authors suggest temporary pin fixation and later removal may reduce complications, though prospective studies are needed.
Veterinary and Comparative Orthopaedics and Traumatology
4
2025
Outcome and Complications Following Medial Patellar Luxation Corrective Surgery with Tibial Tuberosity Transposition Using a Locking Plate and a Pin Fixation: 45 Unilateral and 20 Single-Session Bilateral Procedures
2025-4-VCOT-eskelinen-5
In Espinel Rupérez 2023 et al., on hip toggle stabilization, what was a major cause of technique deviation?
🔍 Key Findings
- Arthroscopic-assisted hip toggle stabilization (AA-HTS) was successfully completed in all 14 feline cadaver joints.
- Femoral and acetabular tunnel creation was feasible in all cases, though femoral tunnel placement had a higher rate of deviations.
- Intraoperative complications occurred in 5/14 joints, mostly related to femoral tunnel creation and toggle lodging.
- Minor articular cartilage injury (<10% total cartilage area) occurred in 10/14 joints, but no injury to neurovascular or intrapelvic structures.
- Thirteen surgical technique deviations (8 major, 5 minor) were identified in 7 joints, all involving the femoral tunnel.
- Toggle passage through the femoral tunnel was the most challenging step, being mildly difficult in 6 joints.
- Postoperative CT and gross dissection confirmed all toggles and buttons were in correct position, without damage to major surrounding structures.
- No deviations, complications, or cartilage injuries occurred in the last 4 joints, suggesting a learning curve effect.
Veterinary Surgery
6
2023
Arthroscopic-assisted hip toggle stabilization in cats: An ex vivo feasibility study
2023-6-VS-espinel-5-cdb86
In Sullivan 2025 et al., on TTT stabilization methods, what theoretical advantage does the spacer pin technique offer?
🔍 Key Findings
- Spacer pin fixation showed no difference in failure force or stiffness compared to tension band wire (TBW) or 2-pin techniques.
- All constructs failed under loads >1000 N, exceeding estimated peak quadriceps force in dogs during walking (~240 N).
- Patellar ligament failure was the most common mode of failure across all groups (5–8 samples per group).
- Distal tibial crest fractures were seen only in 2-pin and spacer pin groups, not in TBW group, suggesting TBW may protect against crest failure.
- No failures occurred at pin tracts, possibly due to pin placement within patellar ligament footprint.
- Spacer pin technique avoids placing pins through the tuberosity, potentially reducing risks of soft tissue complications like tendinopathy or irritation.
- Use of partial osteotomy with robust distal crest may substitute for TBW without compromising initial mechanical strength.
- Further in vivo or cyclic loading studies are required, as this cadaveric study tested only acute tensile failure.
Veterinary and Comparative Orthopaedics and Traumatology
3
2025
Biomechanical Comparison of Spacer Pin Fixation to Two Established Methods of Tibial Tuberosity Transposition Stabilization in Dogs
2025-3-VCOT-sullivan-4
In Banks 2024 et al., what ostectomy position was associated with the most accurate postoperative TPA?
🔍 Key Findings Summary
- Study Design: Retrospective study of 100 radiographs using in silico and clinical data
- Mean preoperative TPA: 28.6°, higher in small dogs than large (p = .02)
- Mean planned TPA (in silico): 7.6°, not achieving 5° target (p < .01)
- Median postoperative TPA: 5.5° overall; higher in small dogs (7°) vs large (4.5°) (p = .06)
- Postoperative ostectomy position: More distal than recommended; average = 8.6 mm
- Increased distalization → greater under-correction of TPA (p = .01)
- Most accurate correction occurred when ostectomy was ≤7.5 mm from patellar tendon
- Wedge angle categories (TPA-Pre minus 5–2°) were used based on pre-op TPA
Veterinary Surgery
1
2024
A mismatch of planning and achieved tibial plateau angle in cranial closing wedge surgery: An in silico and clinical evaluation of 100 cases
2024-1-VS-banks-5
In Moreira 2024 et al., which CCWO technique resulted in the lowest mean prediction error for postoperative TPA?
🔍 Key Findings Summary
- Study Type: In silico 3D modeling of canine tibiae (n = 20 limbs)
- Four techniques evaluated:
- Proximal-centered wedge
- Middle-centered wedge
- Distal-centered wedge
- Slocum-type wedge (based on tibial plateau and cranial cortex)
- Target TPA: 5°
- Most accurate: Slocum technique had the smallest mean prediction error (mean = –0.7°, SD = 0.5°)
- Least accurate: Proximal-centered wedge (mean error = –2.9°, SD = 1.2°)
- Error variation: Prediction error increased with greater initial TPA; high correlation (R² = 0.74)
- Conclusion: Planning based on tibial plateau and cranial cortex (Slocum method) yields better TPA predictability
Veterinary Surgery
1
2024
Predicting tibial plateau angles following four different types of cranial closing wedge osteotomy using patient-specific 3-dimensional computer models
2024-1-VS-moreira-1
In de Moya 2023 et al., on FGPP of femoral capital physeal/neck fractures, what was the median surgical time for FGPP procedures?
🔍 Key Findings
- 11 dogs, 13 fractures (mostly Salter-Harris type I) were repaired with FGPP using Kirschner wires.
- 10/13 fractures achieved satisfactory healing with good limb function at ~43 days median follow-up.
- Major complications occurred in 5 dogs: intra-articular pin placement, implant migration (2), implant failure with nonunion, and malunion.
- 2 dogs presenting >15 days post-injury with radiographic remodeling were poor candidates → higher risk of nonunion/malunion.
- Preoperative displacement was mostly mild (10/13 fractures); these had better outcomes than chronic or severely displaced cases.
- Median surgical time: 60 minutes (range 45–75), all performed percutaneously without conversion to open.
- Elective pin removal was performed in 5 cases; migration occurred with both short and long cut wires.
- Femoral neck resorption (“apple-coring”) was rare (2/10 healed cases) and thought to be less frequent than after ORIF due to reduced vascular disruption.
Veterinary Surgery
7
2023
Closed reduction and fluoroscopic-guided percutaneous pinning of femoral capital physeal or neck fractures: Thirteen fractures in 11 dogs
2023-7-VS-demoya-5
In de Moya 2023 et al., on FGPP of femoral capital physeal/neck fractures, which major complication was reported following FGPP?
🔍 Key Findings
- 11 dogs, 13 fractures (mostly Salter-Harris type I) were repaired with FGPP using Kirschner wires.
- 10/13 fractures achieved satisfactory healing with good limb function at ~43 days median follow-up.
- Major complications occurred in 5 dogs: intra-articular pin placement, implant migration (2), implant failure with nonunion, and malunion.
- 2 dogs presenting >15 days post-injury with radiographic remodeling were poor candidates → higher risk of nonunion/malunion.
- Preoperative displacement was mostly mild (10/13 fractures); these had better outcomes than chronic or severely displaced cases.
- Median surgical time: 60 minutes (range 45–75), all performed percutaneously without conversion to open.
- Elective pin removal was performed in 5 cases; migration occurred with both short and long cut wires.
- Femoral neck resorption (“apple-coring”) was rare (2/10 healed cases) and thought to be less frequent than after ORIF due to reduced vascular disruption.
Veterinary Surgery
7
2023
Closed reduction and fluoroscopic-guided percutaneous pinning of femoral capital physeal or neck fractures: Thirteen fractures in 11 dogs
2023-7-VS-demoya-4
In Mazdarani 2025 et al., on simulated muscle loading, what was the clinical significance of using hip mobility in limb press models?
🔍 Key Findings
- Simulated quadriceps and gastrocnemius forces increased proportionally with axial load in all three femoral fixation models.
- Model 2 (rigid fixation) resulted in subphysiologic quadriceps forces and abnormally high gastrocnemius forces, reducing model fidelity.
- Models 1 and 3 (with hip mobility) produced more physiologic quadriceps and force ratios, especially under 30–40% bodyweight loads.
- Force ratios were significantly lower in rigid fixation (Model 2) compared to hip-mobile models (p = .007), suggesting model design affects simulated muscle coordination.
- Joint angles (stifle and hock) remained within acceptable limits, though slight flexion occurred with increasing load.
- Relative foot position differed by ~3.9 mm between models 2 and 3, with model 2 showing a more caudal position.
- Model 3 preserved benefits of hip mobility while allowing radiographic documentation, making it a preferred setup for future studies.
- The study suggests that models used in feline stifle stabilization research may underestimate physiologic forces, especially with rigid fixation designs.
Veterinary Surgery
5
2025
Proximal femoral fixation method and axial load affect simulated muscle forces in an ex vivo feline limb press
2025-5-VS-mazdarani-5
Quiz Results
You answered 7 out of 10 questions correctly
Key Findings
